"Our findings," lead investigator Dr. Sanjaya Saxena told Reuters Health, "highlight the remarkable and rapid benefits of intensive daily CBT for OCD, even for patients who had not responded well to standard treatment previously."
"There is no doubt," he added, "that intensive CBT should be the treatment of choice for patients whose OCD has been refractory to standard treatments."
In a January 17 online issue of Molecular Psychiatry, Dr. Saxena of the University of California, San Diego, and colleagues note that intensive CBT can produce significant improvement in OCD in as little as four weeks and its effectiveness is well established.
To see whether changes in brain activity could be documented after such a brief period of therapy, the researchers conducted F-18 FDG-PET scans of 10 patients before and after four weeks of CBT. Scans were also made several weeks apart in 12 normal, untreated controls.
CBT consisted of 90-minute individual sessions, five days a week, plus four hours of homework daily.
Significant changes in normalized regional glucose metabolism were seen on PET scans in the patients after CBT. Compared to controls, they showed significant bilateral decreases in normalized thalamic metabolism following therapy.
They also had a significant increase in right dorsal anterior cingulate cortex activity that correlated strongly with the robust degree of improvement in their symptoms.
"Our results should encourage many more clinicians to provide intensive CBT, which is not widely available at present," Dr. Saxena commented.
"They should also spur health insurance companies and other third-party payers to cover intensive CBT -- most currently don't -- because it is highly effective in such a short time, and it clearly has neurobiological effects," he added.
By David Douglas
Last Updated: 2008-02-14 10:06:29 -0400 (Reuters Health)
Mol Psychiatry 2008.
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